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General NPI Number Information
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NPI Number | 1265888481
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Entity Type | Individual
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Provider Name | JUDITH E NOMURA M.A. CCC-SLP, ATP
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Gender | Female
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Dates
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Enumeration Date | 05/06/2016
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Last Update Date | 05/06/2016
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Provider Practice Location Address
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Address Line | 94-428 MOKUOLA ST #305A
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City | WAIPAHU
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State | HI
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Zip | 96797-6300
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Country | US
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Telephone | 808-382-5008
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Fax |
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Provider Business Mailing Address
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Address Line | 2499 KAPIOLANI BLVD APT. 2308
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City | HONOLULU
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State | HI
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Zip | 96826-5310
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Country | US
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Telephone | 808-225-5959
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 504
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 9297
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License Number State | CA
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